Study Of Reconstructing Jaw Defect By Non-direct Guide Osteotransplant

Objective: It is familiar that the resection of the tumor,the external injury, the severity ostemyelitis cause critical size defect (CSD) of the jaw bone in the clinic,as to it's have to carry on repairing a construction. This research applied titanium (Ti) mesh support with the Particulate cancellous bone and marrow(PCBM) compound empress to repairing the defection of the jaw bones, for understanding the effects by non- definite direction marrow of bone reconstruction, to provide the related foundation and conclusion for set up the bones organization engineering of prefabricated-mineralized inducement factor compound.Methods:1. Experiment study: To select 9 female goats as experiment objects. And the angle of the goats mandibular body were formed into the critical (3.5*2.0*2.0 cm) bone defections. Adopting oneself matched-pairs design, the left side defection area placed the grana cancellated bone and marrow compound from the flank bone; the right side bone defection didn't placed any material as blank control group. After the operation, the goats were executed 1, 3, 6 months respectively for the clinical observation, x-ray checking and the histology observation.2. Clinical study: From Jan.2001 to Dec. 2002, 13 jaw bone defected patients (9 men and 4 women) were observed who applied the PCBM and the titanium mesh for reconstruction of the jaw bones. They had been visited for 6-20 months. The wound healing and the graft were observed, and checked by the X-ray.Results:1. Experiment study: Goats had been alive during observation period besides one goat died because of the anaesthesia accident. The operative incisions were primary intention healing. Through the X-ray and the organization pathology, the side of experiment had a great deal of the fiber kind organization, while the side of comparison had born no obvious organization.2. Clinical study: the 13 patients were all been follow-up visited. The shapes of the patients'jaw bones were recovered as the normal ones. The donor site had not abnormal or function obstacle. Showed by the x-ray, the density of the bone which was reconstructed was lower than the surroundings. The operative incisions of the 11 patients were primary intention healing, and 2 patients'mucosas were raw surface for the sharp titanium mesh after the surgery for 6 months and 9 months, but there were not anything that overflowed or inflammatory reaction in the incisions. Then take out the titanium mesh. The grafts were not bone reconstructions by the histology observation.Conclusion:Two sets of case for report, the animals and the patients all filled the bone defection after the surgery, established good shapes, and exercised mastication function of clinical result, but a great deal of fiber organization which replace the normal bone organization set up defection area after the surgery by the X-ray slice and the histology observation.